Rupture of a craniopharyngioma cyst following trauma: a case report

Abstract

There have been only 20 reported cases of non-surgical rupture of a craniopharyngioma cyst, with only 3 cases secondary to trauma. Here we present a rare case of temporary shrinkage of a cystic craniopharyngioma following head trauma. After a motor vehicle accident in May 2001, a 61-year old woman began to have blurred vision and headaches. Magnetic resonance imaging (MRI) of the head revealed a primarily cystic mass measuring approximately two centimeters, involving the sellar and suprasellar area with compression of the pituitary. Visual field testing showed a left hemianopsia and the patient was referred for surgical evaluation. Transsphenoidal drainage of the cystic lesion in November 2001 provided histologic confirmation of the craniopharyngioma. Post-operative MRI showed cyst reduction and visual fields improved. Late in 2002, the patient again experienced progressive visual loss. Repeat MRI revealed a recurrent cystic craniopharyngioma, now measuring approximately three centimeters with subfrontal and parasellar extension and compression of the optic chiasm. A bifrontal surgical approach was advocated; however, prior to the scheduled surgery, the patient sustained a fall with trauma to the head. Following this event she experienced dramatic improvement in her headache and vision and repeat MRI showed the cystic lesion to be significantly decreased in size. Spontaneous rupture of craniopharyngioma cysts is uncommon but has been reported with increasing frequency. It is, however, exceedingly rare for a cyst to rupture following trauma.

Confusion after spine injury: cerebral fat embolism after traumatic rupture of a Tarlov cyst: Case report

“…Less frequently, FES was described after spontaneous or post trauma rupture of craniopharyngioma cyst [11] or after rupture of epidermoid cyst [12]. More recently Aydin et al described, in an experimental model, that pulmonary contusion induced more cerebral fat embolism than long bone fracture and highlighted the importance of lung pathologies in the occurrence of FES [13].…”

Pituitary stalk management during the microsurgery of craniopharyngiomas

“…Craniopharyngiomas (CPs) are non-glial tumors and account for 2–5% of all intracranial tumors (1–3), constituting 6–9% of all childhood intracranial tumors (4–6). The age of onset presents bimodal distribution, mainly in 5–15 and 45–55-year-old individuals (5,7) and does not have a significant gender difference.…”

Aseptic Meningitis Due to Spontaneous Rupture of a Multicystic Craniopharyngioma with an Ommaya Catheter: A Case Report

“…Aseptic meningitis due to rupture of an intracranial tumor is a relatively well-known event, 34 but the spontaneous rupture of CPs causing aseptic meningitis is even more rare with 20 reported patients in the English literature ( Supplementary Table S1 [online only]). 5 8 9 10 12 13 14 15 16 17 18 19 20 21 22 23 24 Such clinical scenario comprises the most frequent clinical presentation of spontaneous CP rupture, which also includes improvement of neurological deficits, 11 27 30 asymptomatic rupture documented on follow-up imaging, 25 31 and vasospasm. 29 There is a considerable increase in spontaneous CP rupture diagnosis after the 1980s, which is associated with the advent of CT and MRI.…”

“… 8 To date, less than 35 cases of spontaneous CP rupture have been reported in the English literature. 5 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Herein, we present a report of an adolescent with a multicystic CP who experienced an episode of aseptic meningitis due to spontaneous rupture of the ventricular cyst, which contained an Ommaya catheter.…”